The cervix is open by 1 cm. Cervical dilatation: norm and pathology, how to change

During pregnancy, the cervix is in a closed position, and before childbirth, it begins to open, helping the fetus to move towards the exit. But often the cervix does not open at all during childbirth, then methods of stimulating the process are used.

The cervix is a tube that is the connection for the internal and external genital organs. According to the norms, during pregnancy, this area should be tightly closed. This is necessary to keep the fetus inside, to protect against external infections.

A couple of weeks before the expected birth, the cervix begins to prepare for the birth of a baby. The organ shrinks, flattens and opens. It happens that changes occur ahead of time. This entails a spontaneous abortion or causes premature delivery, so they try to stop the dilation process with medication. But after such hormonal treatment, the uterus does not open during childbirth.

The cervix begins to prepare for labor from 34 weeks. Her fabrics gradually become softer, but the entrance is still closed. In multiparous at this time, the opening in the cervical canal is one obstetric finger.

By the 37th week of pregnancy, the cervical tissues are already completely softened, and the child has already begun to move towards the small pelvis. In the future, the fetus presses on the canal with body weight, which helps to open it.

At the beginning of labor, the organ quickly smoothes out, shortens and 2 fingers are already being pushed through. During delivery, the opening should reach 10 cm, which will allow the fetal head to come out.

If the cervix does not open before childbirth, the cause of the anomaly is unpreparedness for motherhood, nervous overexcitation or weak contractions. Often the wrong volume of amniotic fluid affects the process of dilatation. If the woman in labor is old-bearing (she is over 35), the low elasticity of the tissues negatively affects the preparation for the birth of the baby. To help the process develop further, you should understand what are the reasons for non-disclosure of the cervix during childbirth.

The reasons

In parturient women, too weak or complete absence of disclosure is observed, which leads to the unpreparedness of the birth canal for the advancement of the fetus. The cause of the pathology is the peculiarity of the female body or medical errors during the preservation of pregnancy.

Why is there no cervical dilatation during childbirth:

very weak contractions;
with great psychological stress before delivery;
excessive strengthening during pregnancy with hormonal drugs in case of premature disclosure;
age over 35 years.

In order for the neck to soften and smooth out, a full-fledged labor activity is needed. This means that the contractions should appear regularly and gradually intensify. With weak spasms of the uterine muscles, there will be no opening.

Often, polyhydramnios or oligohydramnios become the cause of laxity in childbirth. With an excessive volume of amniotic fluid, the uterine muscles are overstretched. Contractile activity deteriorates significantly, so the cervix does not open during childbirth. It happens, and vice versa, that the amount of amniotic fluid is too scarce, a flat fetal bladder cannot cause a full opening.

If a woman in labor is over 35 years old, the tissues in the body are less elastic. It is rigidity that becomes the basis for difficulties with disclosure.

An excess of hormones when strengthening the cervix during gestation negatively affects the process of preparing for labor. If pregnancy persists due to a small opening up to 32 weeks, drug therapy is prescribed, which reduces the activity of opening and strengthens the tissues of the cervical canal.

After such treatment, it is difficult for a woman's body to resume preparation for the birth of a baby, so labor activity is absent at all or too weak. After identifying the grounds for non-disclosure, piece stimulation is prescribed.

Stimulation methods

At this stage, a drug-free or medicinal effect on the course of the birth act is used. There are preparations for opening the cervix, which affect the development of delivery and dilation. Sometimes algae (kelp) is introduced into the cervical canal. The mode of action is that in the humid environment of the vagina, kelp swell and push the organ apart. Substances released when algae come into contact with moisture contribute to faster maturation of the cervical tissues.

Future parents prefer to dwell on the non-drug method of piece opening. This effect is used outside the hospital, but a recommendation from a gynecologist is required before use. It is believed that this method of stimulation is safer for the fetus.

What to do if the cervix is not ready for childbirth:

make a cleansing enema (this entails the onset of contractions, which means there will be an opening);
have sex regularly (sperm softens, and orgasm contracts the uterine muscles);
do housework (doing household chores will help the fetus move through the birth canal, so contractions will begin to intensify faster).

Traditional stimulation is carried out with the help of prostaglandins, hormones that affect a woman's reproductive health. Substances have a positive effect on the muscles and tissues of the uterus. These hormones are not often used for stimulation, they are mainly used for artificial termination of pregnancy.

Gel injection

Medicines are released in the form of gels and suppositories, are introduced into the vagina, do not cause discomfort. Labor activity begins to manifest itself after 30-40 minutes. If the cervix is not ready for childbirth, puncture of the fetal bladder is used. The dilation should start due to the start of delivery. But often after an amniotomy, there are contractions, but there is no disclosure. The reason for this is the artificial impact on the process of the birth of a child.

When carrying out the piercing procedure ahead of time, everything will go with accuracy, but on the contrary, if the child has not inserted the head into the pelvis, there will be no contractions. The fact is that the amniotic fluid above the head of the fetus creates a barrier to exit and soften the neck.

The most common way to treat poor erection is through injections or drips of oxytocin. It is a human hormone produced in the hypothalamus. Its role is to control childbirth and lactation.

The hormone is prescribed to increase the contractile activity of the uterus. The woman in labor feels an increase in spasms of the uterine muscles a minute after the start of the injection. The method is used when the cervix does not open well during childbirth up to 6 cm. With a smaller opening, it makes no sense to start stimulation with oxytocin.

It is important to correctly calculate the dosage, since with excessive administration of the hormone into the body of the woman in labor, placental abruption will occur, bleeding will open, or oxygen starvation of the child will appear. Before stimulation, the causes of the pathology are identified, the optimal method of exposure is prescribed. It is also possible to use alternative medicine as a way to stimulate delivery.

Folk methods

Heating pads are used. To do this, you need to put a heating pad on your stomach with water at room temperature, and between your legs - a bottle of warm water. The effect should be as follows: the child will begin to move from cold to heat and insert the head into the small pelvis. This will help the body to smooth and soften.

Why is the cervix not ready for childbirth:

due to weak contractions;
due to the wrong amount of amniotic fluid;
through medical incompetence;
early rupture of the fetal bladder;
with the rapid development of labor activity

After the causes of poor cervical dilatation have been identified, it is possible to begin to determine the stimulation option. If this is just a post-term pregnancy, and the opening does not occur, it is allowed to use non-traditional means. Although they are painless and not dangerous, it is required to consult an ob/gyn about use in order not to cause harm.

Perhaps the use of herbal infusions to improve the opening. Take nettle, shepherd's purse or barberry. To prepare a drink, you need 1 tbsp. a spoonful of herbs, fruits or leaves, pour 1 cup of boiling water. After that, you need to boil the tea for 5 minutes, leave to cool completely. Take a decoction 3 times 70 g per week.

The following methods are much less commonly used:

bodyflex;
acupuncture;
yoga.

Complications

When the cervix does not open, complications may occur in the postpartum period. You should familiarize yourself with them in advance in order to be as prepared as possible.

Possible risks:

cracks;
gap;
C-section.

If there is no opening, it is realistic to get a gap. The cause of the complication is also a too large fetus, rapid delivery and the appearance of a newborn ahead of schedule.

A deviation is manifested by mild bleeding, the wound is easy to diagnose with a gynecological mirror during an internal examination of the woman in labor. The defect is corrected by suturing the damaged area, but the seams hurt for a long time.

In the complete absence of opening and ineffective stimulation, a conservative method of delivery is used. The baby is removed by caesarean section. Postpartum recovery will be difficult, because fresh scars from the incision of the uterus and abdomen will remain inside. It is more difficult for a woman after a caesarean section to take care of the baby.

There are problems with the health of the child. If the first stage of labor is too long, due to the lack of opening, hypoxia appears in the fetus, as well as breathing difficulties after birth. As a consequence of oxygen starvation, mental abnormalities or defects of the nervous system appear.

Failure to dilate the cervix leads to pathology. It is required to be sufficiently informed about the course of delivery in order to avoid anomalies in labor activity.

At the very end of pregnancy, a woman's body begins to prepare for childbirth. Opening the cervix by 2 fingers is one of the signals that the long-awaited meeting with the baby should happen very soon. However, this does not always mean that the process of future childbirth has already been started and is proceeding correctly. There are various situations when obvious symptoms of disclosure may indicate a pathological course of pregnancy and threaten the health and life of the fetus. To understand what signs indicate the approach of childbirth, you need to know the structure of the female reproductive system and the processes that occur with it as the child is born.

The uterus consists of 3 parts: the fundus, the body of the uterus and the cervix. It has a cervical canal that connects the body of this hollow muscular organ and the vagina. During pregnancy, the internal uterine os is tightly closed. This helps prevent premature birth and protect the baby from infections. An additional barrier to infection of the fetus from the outside is the mucous plug. Before childbirth, the ratio of hormones in a woman's body changes dramatically. The main female hormone estrogen decreases, and the level of oxytocin and prostaglandins increases. It is these hormones that affect the preparation of the reproductive system for an early birth.

What happens before childbirth?

Before childbirth, natural preparation begins for the opening of the internal pharynx, laid down by nature. In the normal course of pregnancy, these processes begin in the body at approximately 36-37 weeks. By 38 weeks of pregnancy, a number of serious transformations should already have occurred in the cervix. From her degree of readiness for childbirth largely depends on how the labor activity will take place. The cervix, in which the necessary changes have occurred for the birth of a child, is called mature. Obstetricians distinguish the following signs:

the uterus goes down;
the birth canal becomes softer and more elastic;
the neck is smoothed and shortened to about 1-2 cm, the entrance to it expands.

Symptoms of cervical dilatation by 1 cm, as a rule, proceed without any features, the expectant mother does not experience discomfort. Only a doctor can see the disclosure, which is at the initial stage, during a routine examination of a pregnant woman. Such examinations in late pregnancy are weekly. The opening of 1 finger is 1.5-2 cm. In women who are pregnant for the first time, this condition may persist for 10-14 days before delivery and is not an indication for urgent hospitalization if all other indicators are normal and the gestational age is less than 40 weeks.

In multiparous women after 37-38 weeks, any symptoms of cervical dilatation may mean that labor will occur within a few hours, since labor can develop much faster than in primiparas. If a woman is expecting a second child, then opening the uterine os by 2 fingers means that she is in labor and hospitalization is necessary.

Finger measurements

Symptoms of uterine dilatation do not appear in any way at the first stage. To find out how the body is ready for childbirth, a woman is examined on a gynecological chair. This procedure includes visual and manual inspection. One of the methods for determining the degree of disclosure, which is most accessible to an obstetrician-gynecologist, is the introduction of fingers into the cervical canal. The unit of measurement adopted in obstetric terminology is the width of the finger. The degree of opening of the neck is deciphered as follows:

The opening of 1 finger is 1.5-2 cm. It is typical for the preparatory stage for childbirth. May be accompanied by sensations of heaviness in the lower abdomen, mild and irregular aching pain in the lumbar region.
Two fingers, freely passing into the cervical canal, indicate the beginning of the active phase of labor, which is accompanied by regular contractions with equal intervals between them. The width of the cervical canal is already approximately 4 cm. The frequency of contractions at this stage is approximately 2-3 contractions per 10 minutes. The fetal head descends into the pelvic area and presses on the uterus, causing it to contract more strongly. This process contributes to the further opening of the pharynx, which reaches 8-10 cm by the beginning of the next stage of childbirth.
Opening for 4-5 fingers is 8-10 cm and is full. At this point, the body is ready to expel the fetus. This means that the baby will be born very soon.

After the transition of labor into the active phase, starting from 2 fingers, the opening of the cervix in women giving birth for the first time occurs at 1 cm per hour, in those waiting for the second and subsequent children, this process occurs much faster.

Premature manifestation

Symptoms of uterine dilatation may indicate a pregnancy pathology that is dangerous to the fetus if the period is less than 38 weeks, and the cervix is open by 2 cm or more. In this case, the pregnant woman needs urgent hospitalization, since such a condition can turn into premature birth. If the opening is 1 finger, then usually doctors prescribe drug therapy and complete rest. While a woman is in the hospital, the condition of the fetus is constantly checked, the heart rate is monitored using cardiotocography, and, if necessary, ultrasound diagnostics with Dopplerography are performed.

When opening the cervix by 2 fingers in women who are at a gestational age of up to 34-35 weeks, doctors take emergency measures to stop preterm labor. One of the ways to stop the process that has begun is suturing the cervical canal. Another common method of stopping premature dilatation is the placement of a pessary.

These measures, combined with taking medications and maintaining complete rest, can stop the onset of labor. Depending on the state of health of the expectant mother and the characteristics of the course of pregnancy, after taking emergency measures, a woman can carry the child to term, despite a slight opening of the cervix.

Organ immaturity

But there is also the opposite situation, when the gestational age is 40-41 weeks, and the symptoms of opening the pharynx are partially or completely absent. This indicates the immaturity of the cervix and its unpreparedness for childbirth. This condition also poses a danger to the unborn child, since by 40 weeks the placenta has exhausted its ability to deliver oxygen and nutrients to the fetus. Prolongation of pregnancy can lead to hypoxia and even asphyxia of the baby.

There are many reasons why cervical dilation symptoms may be absent or false:

structural features of the pelvic organs;
severe stress that interferes with disclosure;
lack of necessary hormones;
severe muscle spasms;
oligohydramnios;
erosion;
age over 35 years.

If the gestational age approaches the day of the expected birth, and the condition of the cervical canal indicates unpreparedness for childbirth, then the attending physician may prescribe some procedures and medications in order to speed up the process. There are several methods, drug and non-drug.

Non-drug methods of accelerating labor activity include:

physical exercises that stimulate the expansion of the cervical canal and the opening of the uterine os (cleaning, long walks, climbing stairs);
sexual contacts (during intercourse, blood circulation in the uterus increases, and seminal fluid contains a large number of prostaglandins that affect the opening of the cervix and provoke the onset of contractions);
cleansing enema (provokes irritation of the posterior uterine wall, which causes expansion of the uterine os).

These methods must be used with caution. After all, excessive physical activity can harm the child. Unprotected sexual intercourse after the mucosal plug has passed can lead to infection of the fetus. Therefore, it is not worth making a decision on the need for such measures on your own. All actions must be coordinated with the gynecologist observing the woman during pregnancy.

Medical stimulation of labor

There are cases when there are symptoms of cervical dilatation, such as discharge of the mucous plug, regular contractions, outpouring of amniotic fluid, but the pharynx of the cervical canal passes no more than 1-2 fingers. This indicates a weak labor activity and requires its stimulation with the help of medications. In medicine, there are several ways to speed up childbirth:

Stimulation with pills containing prostaglandins. This is one of the easiest ways to speed up disclosure. It is a method of preparing for childbirth, and not an emergency measure.
The introduction of a gel with synthetic prostaglandins into the vagina. The procedure is carried out several times a day, monitoring the condition of the patient and the fetus.
Laminaria sticks. They are inserted into the cervical canal, where they swell and gradually mechanically open the cervix.
The Foley catheter also mechanically opens the uterine os and is considered the fastest way to prepare for childbirth.
A dropper with the hormone oxytocin. This method is used most often. Oxytocin stimulates labor activity. Under its influence, disclosure goes much faster, and contractions become more intense.

If medications to stimulate labor do not work, the cervix does not open, and there is a threat to the life of the child, then doctors usually decide to perform an emergency caesarean section.

Cervical dilatation symptoms should not be ignored at any stage of pregnancy. A woman should immediately report any changes in her condition to her doctor. This will help to prevent possible pathologies in time and take all measures to normalize the course of pregnancy and labor.

Childbirth, perhaps, is a truly wonderful, amazing phenomenon of nature, the mystery of which is familiar to us women firsthand. And doctors. It is the people in white coats who do everything possible so that modern women give birth to healthy children, remain healthy themselves and enjoy the delights of motherhood in the future.

For the entire long period of bearing her beloved baby, a woman learns a lot of new things, reads, studies and hears new terms from doctors. Perhaps women with experience who once gave birth feel like a fish in water, and seem to be able to communicate with doctors on an equal footing. What about primiparous girls? Everything is new for them, including these medical "chips", one of which we will deal with today. So, let's talk about dilating the cervix.

A bit of theory

To make it clear what will be discussed in general, it is worth briefly talking about the process of childbirth and the preparation of internal organs for them.

From about 36 weeks, the baby begins its journey, smoothly moving towards the birth canal. The stomach drops, it becomes easier for the mother to breathe, it stops tormenting, but the bladder becomes less “hardy” due to mechanical pressure on it from the uterus.

But not only the baby is preparing for the birth. The uterus, including its cervix, undergoes some changes. During a gynecological examination, you can hear similar words: "opening the cervix by 2 fingers." If you translate into Russian, you get something like this: "Honey, it seems you will give birth soon."

Indeed, shortly before childbirth, the cervix becomes more elastic, undergoes changes. The fetal bladder pressing on her makes her supple, soft, under pressure she still gives up and begins to open up. But, you can collect an alarming bag and be at a low start in the hospital if, say, you heard this at 38 weeks of gestation and later. But it happens otherwise. Opening of the cervical canal long before the due date is a threatening condition and should be eliminated as soon as possible.

So, the process of childbirth itself is usually divided into 3 periods (we will call them as simply as possible):

✓ contractions;

✓ attempts;

✓ the birth of the placenta.

The period of contractions is considered the longest and most painful, it is during this period that the uterine os opens for the subsequent expulsion of the fetus.

Vaginal examination

In the antenatal clinic, upon admission to the antenatal unit or directly in the maternity ward, the doctor, during the examination on the chair, can comment on the condition of the genital organs, in particular, the condition of the cervix. But these comments are not always clear. The doctor, for example, says that the opening of 2 fingers ... when is the birth? Is it good or bad? How much more to walk with a big heavy belly, after all!

In general, disclosure is measured in centimeters, this is accepted everywhere. So, full disclosure is 10 centimeters. But for convenience (since no one will climb there with a tape measure or ruler), doctors use the “obstetric finger” as a unit of measure. It's just more convenient.

During a vaginal examination, the doctor evaluates the nature of changes in the cervix according to some parameters, in particular, studies its size, length, degree of maturity, dilatation, etc.

A loose, flat, supple neck is considered mature, easily passing several fingers into the cervical canal when examined by a specialist. A mature neck is completely ready for the birth of a baby.

During the first stage of labor, during contractions, the doctor can assess the degree of cervical canal dilatation, conditionally measuring the value in the fingers. So one "obstetric finger" is conditionally equal to 1.5-2 cm, respectively, the full disclosure of the uterus is equal to 5-6 "obstetric finger".

When to give birth?

But disclosure does not always mark the beginning of labor. Not always. As already mentioned, the doctor makes a complete assessment based on many criteria. There are cases that the opening of the cervix by 2 fingers in multiparous women was observed from the middle of the gestation period until delivery, and someone "opened" 4-6 hours before the expulsion of the fetus. That is, there are cases when the cervical canal opens a few centimeters, but the neck does not change, it remains dense and elongated. That is why the doctor evaluates the following criteria:

✓ consistency of the neck (loose, dense, soft);

✓ length;

✓ location;

✓ disclosure.

Based on these signs, one can judge the readiness of a woman for childbirth. It often happens that the still immature cervix opens by 3-4 cm, but there are still a few weeks before delivery. But, in most cases, the stretching of the uterine pharynx by 4-5 itself, and this is just about 2 fingers, indicates the onset of labor and the presence of tangible contractions about once every 7 minutes.

In turn, they speak of full disclosure with 8-10 centimeters or a width of the uterine os of 4-5 fingers, a lowered fetal head and regular contractions with a short interval.

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Opening phases

Let's take a closer look at the process itself. The opening of the cervical canal is usually associated with the onset of contractions. With their onset or shortly before this moment, a woman may notice the discharge of cervical mucus (plug), which closes the entrance to the uterus and performs barrier functions. The passage of the cork is individual. Someone notices a gradual discharge of portions of mucus a week or two before giving birth, for someone the cork comes out with the onset of contractions.

The stretching itself and the preparation of the cervical canal are divided into 2 phases that are included in the first phase of childbirth:

Latent phase

It is characterized by systematic contractions of the uterine myometrium, occurring approximately every 5-7 minutes. At first, contractions may be painless or cause some discomfort to the woman, but there is usually no pronounced pain syndrome. The period is quite long and lasts about 5-8 hours in nulliparous women. At this point, it is important to recognize true contractions (unlike false ones, they are constant, with a regular, ever-shrinking interval) and not put off a trip to the maternity hospital if you are not already there. Each contraction of the uterus shortens the cervix, flattening and opening it. Opening dynamics: about half a centimeter per hour;

active phase

It is shorter than latent and is marked by intensive opening up to 8-10 cm. The contractions are already strong, painful and frequent, about once every 1-2 minutes. The cervix opens faster and more, the head of the fetus sinks to the pelvic floor. Opening the cervix by 1 finger per hour is typical for the active phase. In the active phase, the fetal bladder itself no longer withstands pressure, bursting and provoking an outpouring of water. The woman begins to feel the desire to push, which is a harbinger of the onset of the second stage of labor. However, it is worth considering the position of the presenting part of the fetus (head, buttocks with breech presentation). It is impossible to push if she has not yet sunk to the pelvic floor, and the uterine os is not fully opened.

In the second phase, premature rupture of the membranes (PROM) may occur: the pharynx is less than 7 cm open, but the bubble has already burst. The evacuation of waters is considered timely when opening 8-10 cm.

When outflow, the doctor is obliged to assess the nature of the amniotic fluid. The waters are clean, with a neutral smell are considered the norm, but an alarming sign is the outpouring of muddy, greenish waters with an unpleasant odor. This symptom is a symptom of intrauterine fetal hypoxia (lack of oxygen) and requires urgent action. The original feces from the rectum of the fetus enters the fluid of the amniotic sac, and can enter the respiratory tract of the child.

Pathological conditions

As mentioned, everything does not always happen on time, and the cervix can begin to open long before the baby is ready to be born. In this case, it is necessary to make every effort to ensure that the pregnancy is maintained and reaches the due date. In the event of a similar situation, a woman is diagnosed with "isthmic-cervical insufficiency" or abbreviated ICS.

This pathology is explained by the fact that the cervix cannot cope with its functions, which are currently protective and holding the fetus in the uterine cavity. Under the pressure of a growing baby, due to injury or imbalance of hormones, it stretches, provoking disclosure.

In this case, the priority is to preserve the pregnancy with medication and adherence to the regimen. Sometimes surgery is required by suturing or installing a special restraining ring.

It's time to give birth, but the body is in no hurry

The situation is reversed, when 40 weeks are already on the way or the 41st has gone, and there are no forerunners, including the uterine pharynx is in no hurry to open. Doctors soften and stretch the "oak" neck medically or mechanically by prescribing hormonal suppositories and gel or stretching the neck with kelp, air balloon, etc.

A woman herself can help start the process and move the fetus to the pelvic floor by stimulating the production of prostaglandin hormones. Many experts advise in the last stages of pregnancy to stimulate disclosure on their own.

How to give birth faster and speed up the preparation of the uterine os:

Physical exercise

Strong and adequate, of course. This is swimming, walking in the fresh air, gymnastics for pregnant women, any physical activity stimulates the descent of the fetus and the maturity of the uterine pharynx;

Sex

Orgasm provokes the production of the hormone oxytocin, which triggers the contraction of the uterus, and, accordingly, the opening of the cervix. It is worth mentioning the composition of sperm (contains prostaglandins), and the mechanical effect, and the stimulation of a woman's nipples during intercourse. But here you need to be careful: in order to avoid infection, this method should be excluded if the cork has already come out (partially out) or;

Enema and diet

A direct dependence of the fullness of the intestine and contraction of the uterus was revealed. The emptying of the bowel stimulates the opening. Including a special diet containing fresh vegetables helps to avoid constipation and timely evacuation of the contents of the rectum.

Conclusion

Overcoming a long way from conception to childbirth, a woman is faced with many new phenomena, opens herself from the other side. In order to maintain a pregnancy and give birth to a healthy child, the expectant mother must be aware of the possible phenomena and conditions that she will face.

So, the opening of the cervix heralds the onset of labor, which may not always begin on time. A woman should warn this when it is not yet time to give birth, in a timely manner and immediately contacting a doctor. During contractions, the degree of opening of the uterine pharynx, which the obstetrician-gynecologist who leads the birth necessarily comments on, allows the woman in labor to assess the situation and estimate the approximate time before the start of attempts. If a woman "walks", then after the examination, she can also understand from the comments of a specialist how ready her body is for the emergence of a new life.

It is important to fully comply with the recommendations of physicians during childbearing and in preparation for childbirth. Already in the delivery room, it is extremely important not to panic, not to get lost, to fully and unquestioningly listen to the doctor leading the birth, the midwife, to remember all the theory that you studied earlier. In particular, it does not hurt to learn and practice breathing and relaxation techniques. Since the opening of the cervix and the contractions themselves are a long and painful process, the ability to “breathe” the contraction will save energy for energy-consuming attempts and the birth of the placenta.

When the pregnancy comes to its natural end, a woman, during an examination on a gynecological chair, can hear from a doctor that her cervix has dilated by 1 finger. What does it mean? Is it necessary to pack things in a hurry, because the baby is already “on the way”? How long does it take to give birth?

Whymeasure how much the cervix has dilated?

The cervix (CC) is a kind of cylindrical canal that connects this organ with the vagina. Its length is only 4 cm. In the last stages of pregnancy, it becomes shorter and softens, and then completely smoothes out to miss the baby.

To determine how a woman's body is ready for childbirth, measure the amount of cervical dilatation. If it is already on 1 finger, then in a week and a half (if this is the first child) or even much sooner, after a couple of days (if this is a repeated birth), the baby will be born.

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If, at the time of 38-39 weeks (when the CMM begins to open), the cervix is still elastic and its length is 3 cm, but it has already opened by one finger, then you can postpone the trip to the hospital for the time being.
The disclosure is checked in order to roughly imagine at what stage the woman in labor is and whether it is necessary to transfer her to the delivery room. If the doctors assign her the status of "actively giving birth", such a check will be done every 4 hours, and if the opening of the CMM is late, then they will stimulate labor.

Secretthe language of obstetricians: what do doctors talk about when childbirth occurs?

So, according to the opening of the cervix, the doctor concludes whether it is mature or not, that is, when to expect the onset of labor. Sometimes obstetricians use the number of fingers as a measure of this process, and in other cases they determine it in centimeters. How to understand that one finger and one centimeter are one and the same? And what does this indicator tell the doctor?

Here's what it means:

if the cervix has opened by 1 finger, then the opening is from 2 cm. At this stage, no one will be able to name the exact date of birth. But the maximum period that the baby will spend in the mother's tummy will be no longer than 1.5 weeks. Usually a woman does not feel an opening for a couple of centimeters, but for some this process is accompanied by pulling pains in the lower abdomen, which is similar to menstrual pain;
the opening of the cervix by 1.5 fingers is about 3 cm. In this phase, there are also no strong painful sensations, since the active birth process has not yet begun;
if the cervix has opened by 2 fingers (up to 4 cm), this indicates the beginning of regular labor activity - about 3 contractions in 10 minutes. At this stage, the muscles of the uterus are smoothly compressed, and the CMM is drawn into its cavity;
if the patency of the cervical canal has reached 4 fingers (8 cm), then the dynamics of labor is rapidly increasing. Muscle contractions are repeated every minute;
full disclosure - 5 fingers (10 cm). The woman in labor begins to feel pushing. The membrane is torn and water is poured out. The baby's head descends to the pelvic floor and is palpated through the labia. The opening diameter becomes equal to the girth of the head of the little one. The woman is transferred to the delivery room.

Howindependently learn about the disclosure?

Is it possible and how to determine the dilatation of the cervix at home? There is nothing super complicated and mysterious in this procedure, and it is not necessary to be an obstetrician to implement it. But two points must be taken into account. First, hygiene should be observed (although, until the water has broken, it is almost impossible to infect). And second: if the scheduled date of birth is still far away, then it is better not to “look for” your neck, because this can provoke contractions.

Here's how it's done: you need to squat down, spread your legs apart, insert two clean fingers - index and middle - into the vagina (you can pre-lubricate your hand with oil). They should be advanced all the way until a rounded bulge with a recess is felt. If the disclosure is already taking place, then a hole will be found here. It is necessary to very carefully insert a finger into it, and then the second and slowly try to spread them apart. Then, without changing position, you need to manage to remove them from the vagina. Then everything is simple - attach them to the ruler and measure the distance.

And here is another way, albeit controversial. It is called the purple (red) line method and consists in observing the strip formed on the gluteal crease. As the CMM opens, it rises from the anus upwards, and when the opening reaches its maximum, the line reaches the place where the gluteal fold begins. But such a band is not noticeable to everyone.

According to experienced midwives, you can go to the maternity hospital for 6-7 cm of disclosure.

Howreduce cervical dilation time at home: practical tips

There are several methods of self-stimulation of uterine activity. How to speed up the opening of the cervix at home? To do this, you can walk up the stairs or just walk, swim, dive, tilt and rotate the body. To speed up this process, it is recommended to take a warm bath. Massage of the little finger and earlobe also helps. You can also do exercises to strengthen the muscles of the perineum and breathing exercises. To speed up the result, it is permissible to use a cleansing enema.

When the nipples are stimulated, oxytocin is released, a hormone that causes uterine contractions. The same effect gives sex. This helps ripen the cervix and also brings the uterus into an active state. In addition, prostaglandin is present in the semen, which has the most positive effect on the maturation of cervix.

Home methods are quite effective, but, according to doctors, it is better not to interfere with the disclosure process.

In order to help everyone who wants to prepare for childbirth, we have created a School for Future Parents on the pages of our magazine.

One of the most important tasks of any course for future parents is to help get rid of the fear of childbirth. This fear is “enemy number one” for the woman in labor and the doctors helping her. Fear paralyzes the will, does not allow relaxation, and significantly increases pain. The reason for fear is simple: it is human nature to be afraid of the unknown. After all, most of our readers will have their first birth. That is why we decided to tell you in detail about the stages of development of labor activity - from the very first contraction to the moment when you can press the baby to your chest.

Labor activity is a rhythmic contraction of the uterus - contractions. These contractions help the baby to leave the uterine cavity and be born into the world. Contractions alternate with periods of relaxation of the uterus - intervals. Between contractions, the woman in labor does not experience any subjective sensations, except for the accumulated fatigue. From such contractions, alternating with relaxation, childbirth consists. At first, the contractions are short (a few seconds), and the intervals are long (up to half an hour). Then, as the labor activity develops, the contractions intensify and last longer, and the intervals are gradually reduced. This development of the process is called the dynamics of labor activity.

I stage of labor

This stage is also called the cervical dilatation period. The uterus can be imagined as an inverted vessel, the bottom of which is located on top, and the "neck" - the neck - is turned down, towards the vagina. Inside is a fetal bladder filled with water, and in the bladder is a baby. In order for a baby to be born, the cervix must first dilate enough to allow the head to pass through. It is this process - the opening of the cervix - that accounts for the first stage of labor. It is the longest (more than 2 / 3 of the entire process of childbirth) and requires the most patience from the woman in labor.

By the time labor begins, the woman's body has already undergone some preparation. The cervix softened, and the cervical canal - the opening in the cervix connecting the vagina to the uterine cavity - opened up so much that it was able to pass the tips of the obstetrician's two fingers.

With the first contractions, which usually last 5-7 seconds, and the interval between them is 20, 30, and sometimes even 40 minutes, the cervix begins to shorten. Doctors call this process cervical smoothing. Approximately after 1.5-2 hours, the neck is finally smoothed out, i.e. ceases to protrude into the vagina and turns into just a round hole in the uterus. At the time of smoothing the neck, the hole in it is 2 cm, the contractions last about 10 seconds, and the interval approaches 15 minutes. Now the actual opening of the cervix begins. After another 1.5 hours, the interval between contractions is reduced to 10 minutes, and the contractions themselves last for 15 seconds. The cervix dilates 3 cm at this time.

Before the interval between contractions is reduced to 10 minutes, the woman in labor can be at home. Naturally, this is possible only if you feel well, in the absence of signs of amniotic fluid leakage or bleeding. As soon as there is an interval between contractions of 10-12 minutes, it's time to go to the hospital!

In obstetrics, it is customary to divide the first stage of labor into latent and active phases. This division is conditional and is based on the activity, or speed of development of labor activity. The latent phase, from which, in fact, labor begins, is characterized by short, most often non-painful contractions, alternating at significant intervals. The opening of the cervix in this phase occurs rather slowly: in 4.5-5 hours (and this is about half of the first stage of labor! ) - only 4 cm. From the opening of 4-5 cm, the situation is gradually changing. Labor activity becomes more active, contractions are longer and more noticeable, intervals are shorter, and the cervix opens faster. The active phase of the first stage of labor begins.

Approximately 4-5 hours after the onset of labor, contractions last at least 20 seconds, and the interval between them is 5-6 minutes. This frequency of contractions usually corresponds to 4 cm of cervical dilatation. At the same time, due to increasing contractions of the uterus, the fetal bladder may open.

After the outflow of amniotic fluid, contractions intensify and gradually become painful. After 1.5 hours, the neck opens by 6-7 cm; contractions last for half a minute, the interval is 3-4 minutes. If labor activity develops according to the classical scheme, i.e. without any violations, then after 1.5-23 hours there is a complete opening of the cervix. By this term, doctors refer to the size of the opening of the cervix, equal to 10-12 cm, through which the baby's head can pass. Full opening is accompanied by very frequent (after 1-2 minutes) and long (up to 1 minute) contractions. After the cervix has fully opened, the baby no longer has any obstacles in the way: he can leave the uterus and move along the birth canal to the exit. The first stage of childbirth is over.

II stage of labor

The next period is called straining, or the period of expulsion of the fetus. The contractions of the uterus push the baby down the vagina. During contractions, the woman in labor experiences a sensation similar to the need to empty the intestines. This feeling is caused by the fact that the baby presses the head against the walls of the vagina and irritates the rectum located nearby. In response to this feeling, the expectant mother has a strong desire to push. An attempt further advances the child through the birth canal, bringing the moment of birth closer,

Contractions in the pressing period become shorter than at the end of the first period; now they last about 30-35 seconds, and the interval is extended to 3 minutes. Soreness at the beginning of the fight is quickly replaced by a strong desire to push; pushing brings relief.

The very moment of the birth of a baby is accompanied for the mother by strong physical stress rather than pain. The fact is that the child's head stretches the tissues of the perineum so much that the blood supply to them is temporarily disturbed. Without a blood supply, it is impossible to transmit a nerve impulse, which is a pain signal. Therefore, there is no pain in the perineum, which future mothers are so afraid of, at this moment. There is only a feeling of fullness inside the vagina, created by the baby. II stage of labor ends with the birth of a baby.

III stage of labor

After the birth of the child, the last, shortest period of childbirth begins. It is called afterbirth. For some time, the woman in labor does not feel contractions. Then there is a contraction that is insignificant in strength (as at the beginning of the first stage of labor). Simultaneously with the contraction, a small amount of blood is released from the genital tract. These phenomena indicate that the placenta, which has so far remained inside, has separated from the uterine wall. The woman in labor is offered to sweat, so that the afterbirth is born - the placenta with fetal membranes. From the moment of allocation of the placenta, childbirth is considered completed.

So let's sum it up:

I period- disclosure of the cervix - begins with the first regular contractions and ends with the complete opening of the cervix; normally it lasts no more than 9.5 hours /

II period- expulsion of the fetus, or pushing, - begins with the complete opening of the cervix and ends with the birth of the baby; normally lasts no more than 2 hours.

III period- afterbirth - begins from the moment the baby is born and ends with the release of the placenta; normally lasts no more than half an hour.

The cervix is ​​open by 1 cm. Cervical dilatation: norm and pathology, how to change